Pruritic Folliculitis Of Pregnancy Research Articles

A Study of Specific Dermatoses and Skin Disease Affected by Pregnancy

Background and Aim: Pregnancy associated skin diseases or changes can be physiological (hormonal), skin pre-existing disease, and development of dermatoses with new pregnancy. The specific skin dermatoses related to pregnancy involve eruption of pruritic skin in poorly defined heterogeneous group. The present study aimed to evaluate the specific dermatoses and skin disease affected by pregnancy. Methodology: This cross-sectional study was carried out on 226 pregnant women in the Department of Dermatology and Obstetrics and Gynecology of Dow University Hospital, Karachi from June 2021 to November 2021. All the patients were investigated for pregnancy associated cutaneous changes. The presence of any concomitant dermatoses that developed during pregnancy was investigated. Detailed clinical examination was performed on pregnant women with specific dermatoses of pregnancy regarding pattern, distribution, and morphology of lesions. All the pregnant women undergone through routinely blood investigation. Results: Of the total 226 pregnant women, the incidence of specific dermatosis during pregnancy was 27 (11.95%). Prurigo of pregnancy (5.8%) was the prevalent specific dermatosis of pregnancy. The incidence of intrahepatic cholestasis of pregnancy (ICP), pruritic urticarial papules and plaques of pregnancy (PUPP), and pruritic folliculitis of pregnancy (PFP) was 0.41%, 3.9%, and 0.17% respectively. All these skin diseases were caused by pregnancy in 11.95% of females. Conclusion: The present study found that Prurigo of pregnancy was the prevalent dermatosis of pregnancy that occurred in the multigravida second trimester. The rare dermatosis with no primary lesion was intrahepatic cholestasis of pregnancy. The course of pregnancy-associated disease changes, in turn, causes exacerbation like psoriasis, vitiligo, and dermatosis. Keywords: Specific Dermatoses, Skin disease, Pregnancy

The complex implications of dermatoses specifically associated with pregnancy

Pregnancy-specific dermatoses are a heterogeneous group of inflammatory dermatoses associated exclusively with pregnancy. Although these dermatoses are rare, it raises problems in medical practice because of their appearance, being difficult to diagnose, treat and the possibility of the fetus being affected. Pemphigoid Gestationis (PG) is a rare, autoimmune, strongly pruritic, vesiculobullous dermatosis with a strong impact on the patient. Polymorphic Eruption of Pregnancy (PEP) is a benign, self-limited inflammatory skin disorder that usually affects first pregnancy in the third trimester or immediately in the postpartum period. Other dermatoses associated with pregnancy include: Intrahepatic Cholestasis of Pregnancy (ICP), Atopic Eruption of Pregnancy (AEP) and Pruritic Folliculitis of Pregnancy (PFP). We will extensively present PG and PEP, to draw attention to the importance of correct diagnosis and the implications of treatment during pregnancy.

Study of Specific Dermatoses of Pregnancy and Skin Diseases affected by Pregnancy in a Tertiary Care Rural Hospital

Abstract Aims and objectives: To study the various specific dermatoses of pregnancy and changes due to pregnancy. Study design: A cross-sectional study was conducted in a tertiary care center, Department of Dermatology and Department of Obstetrics and Gynecology. Materials and methods: A total of 400 pregnant females were enrolled and studied for various cutaneous changes of pregnancy. In pregnant females with specific dermatoses of pregnancy, detailed clinical examination was done regarding the morphology, pattern, and distribution of lesions. Routine blood investigations were done in all pregnant females. Biopsy was done wherever required. Results: Among 400 pregnant females, we found 38 (9.5%) to be having specific dermatosis of pregnancy. The most common specific dermatosis of pregnancy was prurigo of pregnancy (4.75%), followed by pruritic urticarial papules and plaques (PUPP) of pregnancy (4%), intrahepatic cholestasis (ICP) of pregnancy (0.25%), and pruritic folliculitis of pregnancy (0.125%). In 9.5% females, skin diseases were caused due to pregnancy.

Dermoscopy as a diagnostic aid for pruritic folliculitis of pregnancy

Pruritic folliculitis of pregnancy is a noninfective dermatosis of the gestation period characterized by multiple pruritic follicular papules and/or pustules which is not uncommonly mistaken for other similar skin disorders that may occur during pregnancy. In the present article we describe the usefulness of dermoscopy as a supportive diagnostic tool in a case of pruritic folliculitis of pregnancy. The main (always present) dermoscopic clue consisted of a vellus hair in the centre of each papule/pustule. Moreover, most papules showed a central yellowish-orange hue with some dotted vessels and irregular haemorrhagic spots. The detection of the aforementioned dermoscopic features might help distinguish pruritic folliculitis of pregnancy from its main differential diagnoses, mainly including microbial folliculitis, prurigo lesions, and the papular stage of pruritic urticarial papules and plaques of pregnancy, as they typically show different dermoscopic patterns. ( J Dermatol Case Rep . 2016; 10(1): 19-20)

Prurigo, pruritic folliculitis, and atopic eruption of pregnancy: Facts and controversies

Prurigo (PP) and pruritic folliculitis of pregnancy (PFP) are poorly characterized entities. Traditionally classified under specific dermatoses of pregnancy, they were reclassified under a new umbrella entity, atopic eruption of pregnancy (AEP), which also includes atopic dermatitis (AD) that can worsen or present for the first time in pregnancy. Still, several aspects of AEP have not been adequately elucidated. It needs to be clarified whether it is the intrinsic (“nonallergic” or “atopiform dermatitis”) or extrinsic (immunoglobulin E–associated) AD that is affected by pregnancy. Future studies need to examine the postpartum prognosis of AD that develops for the first time during gestation. A revision of diagnostic criteria of AEP will allow a more accurate estimate of its prevalence, as well as clarification of the relationship between AD and specific dermatoses, such as PP and PFP. In this context, this review discusses the history, epidemiologic data, clinicopathologic features, and management of these entities.

PREGNANCY

Objective: To determine frequency and pattern of skin changes duringpregnancy. Study Design: Cross sectional study. Setting: Outpatient department ofDermatology and Gynaecology at Dow University Hospital, Ojha campus in Karachi. Period:May 10, 2013 and January 10, 2014. (8 months). Patients & Methods: It comprises 80consecutive pregnant women with skin problem, who presented in outpatient department ofDermatology with referral cases from Obs&Gynae outpatient department.Information wascollected on predesigned questionnaire after taking informed consent. Results: Total 80pregnant women were included in study with different skin problems. The results indicatethatmost of women 72.5% presented during third trimester and 43.8% women were primigravida.Striagravidarum and lneanigra was commonest physiological changes, reported in 54%, 52%women consecutively. Eczema,utricaria and candidiasis were reported in 16.3% and 15% and15% women consecutively. Prurigo of pregnancy was reported in 17.5% followed by pruriticfolliculitis of pregnancy in 6.3% women. Conclusions: This study concluded that skin changesduring pregnancy are frequent in Pakistani women. These changes could be physiological orpathological.

A study on dermatoses of pregnancy

Certain dermatoses are specifically seen in pregnancy or postpartum period. It is therefore important for the clinicians to recognize and treat these cutaneous disorders to minimize maternal and fetal morbidity. The commonest pregnancy related dermatoses was polymorphic eruption of pregnancy seen in 22% patients, prurigo of pregnancy was seen in 7% patients, pemphigoid gestationis was seen in 3% patients, pruritic folliculitis of pregnancy was seen in 2% patients and intrahepatic cholestasis was seen in 1% of patients. It was seen that the skin disorders were commonest in the third trimester (60%), followed by 31% patients in second trimester and 9% patients in first trimester.

Dermatoses of Pregnancy

Pregnancy is frequently associated with major skin changes. Some of these changes are attributed to pregnancy-specific dermatoses, which often are overlooked and misdiagnosed by physicians. We discuss four major pregnancy-specific dermatoses: pemphigoid gestationis; pruritic urticarial papules and plaques of pregnancy; prurigo of pregnancy; and pruritic folliculitis of pregnancy. Accurate diagnosis and management is crucial, not only to alleviate symptoms, but also to estimate correctly the risk for the fetus.

Pregnancy Dermatoses

Some aspects regarding the etiology and the nosologic classification of various pregnancy dermatoses are highly controversial. While some authors highlight the existence of premises allowing several skin disorders to be re-grouped within broader disease concepts, others underline the absence of clear, undisputed etiopathogenetic data that could support such classifications. This review exhaustively analyzes the various pregnancy dermatoses (pemphigoid gestationis, intrahepatic cholestasis of pregnancy, impetigo herpetiformis, polymorphic eruption of pregnancy, and the papular dermatoses of pregnancy [prurigo of pregnancy, pruritic folliculitis of pregnancy, and the new classification, atopic eruption of pregnancy]) in an attempt to shed light over this confusing and disputed domain, while subsequently offering an algorithmic approach to their diagnosis and management. While for pemphigus gestationis, intrahepatic cholestasis of pregnancy, and impetigo herpetiformis, specific diagnostic tests such as histopathology, immunofluorescence, or laboratory investigations will confirm the diagnosis, the identification of the other types of pregnancy dermatoses is based only on clinical criteria. In this context, the review argues for the inclusion of the whole group represented by the papular dermatoses of pregnancy within the broad spectrum of polymorphic eruption of pregnancy, separating each of these entities by focusing on their onset: early-onset polymorphic eruption of pregnancy (comprising prurigo of pregnancy, pruritic folliculitis of pregnancy, and atopic eruption of pregnancy) and late-onset polymorphic eruption of pregnancy. In light of the same practical approach guiding it, the review provides updated treatment strategies for each of these conditions.

Specific dermatoses of pregnancy: advances and controversies

Specific dermatoses of pregnancy include herpes (pemphigoid) gestationis, polymorphic eruption of pregnancy (also known as pruritic urticarial papules and plaques of pregnancy), prurigo of pregnancy and pruritic folliculitis of pregnancy. This article focuses on what is currently known about the epidemiology, clinical characteristics, etiopathogenesis and management of these disorders. Moreover, it discusses the intrahepatic cholestasis of pregnancy and ‘atopic eruption of pregnancy’, which were recently reclassified as specific dermatoses of pregnancy, as well as debates related to the prevalence and diagnostic criteria of the latter. Finally, it addresses the suggested overlap between ‘atopic eruption of pregnancy’ and specific dermatoses of pregnancy, such as prurigo and pruritic folliculitis.

Spezifische Schwangerschaftsdermatosen: Klinik, Differenzialdiagnosen und Therapiemöglichkeiten

The specific dermatoses of pregnancy encompass several distinct clinicomorphological entities, including pemphigoid gestationis, polymorphic eruption of pregnancy, intrahepatic cholestasis of pregnancy, prurigo of pregnancy and pruritic folliculitis of pregnancy. Pruritus is one of the leading symptoms of specific dermatoses of pregnancy, differentiation of the diseases is possible by characteristic clinical aspects together with laboratory or histopathological findings. There are topical and systemic treatment options that meet the requirements for the expectant mother and the foetus. In this context, glucocorticosteroids and antihistamines are important therapeutic agents. Intrahepatic cholestasis of pregnancy is best treated with ursodeoxycholic acid. Hydratising emollients should be part of each therapeutic setting.

Pityrosporum folliculitis during pregnancy is not pruritic folliculitis of pregnancy

Pityrosporum folliculitis during pregnancy is not pruritic folliculitis of pregnancy

Ultraviolet phototherapy for pruritus

Ultraviolet-based therapy has been used to treat various pruritic conditions including pruritus in chronic renal failure, atopic dermatitis, HIV, aquagenic pruritus and urticaria, solar, chronic, and idiopathic urticaria, urticaria pigmentosa, polycythemia vera, pruritic folliculitis of pregnancy, breast carcinoma skin infiltration, Hodgkin's lymphoma, chronic liver disease, and acquired perforating dermatosis, among others. Various mechanisms of action for phototherapy have been posited. Treatment limitations, side effects, and common dosing protocols are reviewed.

Pityrosporum folliculitis during pregnancy: A possible cause of pruritic folliculitis of pregnancy

Pityrosporum folliculitis during pregnancy: A possible cause of pruritic folliculitis of pregnancy

Specific dermatoses of pregnancy: An evidence-based systematic review

Objective: We conducted an evidence-based systematic analysis of the literature on specific dermatoses of pregnancy. Study Design: The bibliographic databases MEDLINE and EMBASE were screened for studies and reports in all languages about herpes gestationis, pruritic urticarial papules and plaques of pregnancy, pruritic folliculitis of pregnancy, and prurigo of pregnancy from January 1962 to January 2002. As main index terms, including analogs and derivatives, we used the names of specific dermatoses of pregnancy. Intrahepatic cholestasis of pregnancy, not a primary dermatosis, was included herein because this disorder is associated with pregnancy and its secondary skin manifestations must be differentiated from specific dermatoses of pregnancy. Other sources were abstract books of symposia and congresses, theses, textbooks, monographs, reviews, editorials, letters to the editor, free or rapid communications, and the reference lists from all the articles that were retrieved. All articles selected for inclusion in this review were evaluated critically with regard to their impact factor and evidence-based contribution to this field, as measured by their citation index and impact factor of the journal in which they were published. Approximately 39% of articles met the selection criteria. Results: The clinical features and prognosis of the specific dermatoses of pregnancy have been delineated through a number of retrospective and cohort studies. The molecular biologic and immunogenetic properties of herpes gestationis, pruritic urticarial papules and plaques of pregnancy, and intrahepatic cholestasis of pregnancy have been further clarified. A meta-analysis in this review reveals a higher prevalence of multiple gestation pregnancy (11.7%) among patients with pruritic urticarial papules and plaques of pregnancy. Several investigations have unraveled the fetal complications in intrahepatic cholestasis of pregnancy and herpes gestationis. New treatment modalities in intrahepatic cholestasis of pregnancy (cholestyramine, ursodeoxycholic acid) and herpes gestationis (cyclosporin, intravenous immunoglobulin, and tetracyclines postpartum) have shown promise and warrant further evaluation. Conclusion: During the past few decades, a significant amount of new data has provided new insights into the classification, pathogenesis, treatment, prognosis, and fetal risks that are associated with the specific dermatoses of pregnancy. (Am J Obstet Gynecol 2003;188:1083-92.)

Dermatoses of pregnancy

A broad background in dermatology is certainly something most obstetricians and gynecologists do not have. Likewise, our knowledge regarding the various skin conditions that are associated with pregnancy is also usually quite deficient. The review “Specific Dermatoses of Pregnancy: An evidence-based systematic review” by Kroupmouzos and Cohen1Kroumpouzos G Cohen LM. Specific dermatoses of pregnancy: an evidence-based systematic review.Am J Obstet Gynecol. 2003; 188: 1083-1092Abstract Full Text Full Text PDF PubMed Scopus (116) Google Scholar is a very scholarly presentation of the subject that rarely is alluded to in the obstetric and gynecologic literature. One of the important points that is emphasized by the authors is the proper classification and the treatment of the various dermatoses that are peculiar to pregnancy. There is considerable confusion regarding the various terms that are used to describe these dermatoses, and the authors have done an excellent job in clarifying what should be the appropriate terminology. They discuss herpes gestationis, pruritic urticarial papules and plaques of pregnancy, pruritic folliculitis of pregnancy, prurigo of pregnancy, and intrahepatic cholestasis of pregnancy. It is important for the obstetrician to distinguish these various skin changes because the prognosis for the pregnancy varies significantly for some of them. They have carefully described the characteristics of the skin changes that are seen in each of the dermatosis that are covered and point out how one can differentiate them. This is of extreme clinical importance because individuals with intrahepatic cholestasis of pregnancy and herpes gestationis have pregnancy outcomes that are significantly worse than seen in patients with other dermatosis. An understanding of the negative impact on pregnancy outcome in association with these two disorders is of significance because, in many cases, the clinician may want to consider early delivery of the infant; there appears to be a medical therapeutic choice of using ursodeoxycholic acid in the treatment of intrahepatic cholestasis of pregnancy. It remains to be seen whether this approach to treatment will result in superior pregnancy outcomes. It is also important for the clinician to recognize and correctly diagnose the various dermatoses that are seen in pregnancy so that they can counsel their patients informatively on the likelihood of recurrence in future pregnancies. For example, herpes gestationis frequently will recur, as may intrahepatic cholestasis of pregnancy and prurigo of pregnancy. This is especially important in the patients with intrahepatic cholestasis of pregnancy and herpes gestationis. Fortunately, all these dermatoses appear to resolve after delivery. One exception might be seen in the individual who is diagnosed with herpes gestationis who, in actuality, has bullous pemphigoid, which can be quite similar in clinical appearance. Unfortunately, many of our dermatologic colleagues are not very knowledgeable about the dermatoses that are associated with pregnancy. Thus, it is incumbent on the practicing obstetrician to be knowledgeable and, when necessary, to seek dermatologic consultation with a dermatologist who is knowledgeable in this area.

Dermatosis específicas del embarazo. Actualización

Abstract.—Pregnancy dermatoses are a group of disorders that occur as a consequence of inmunologic and metabolic changes in pregnant women. The terminology has become increasingly confusing with various names in use for analogous clinical entities. During the last 15 years a great effort has been performed to rationalize the nomenclature and a clinical classification is getting to be consolidated. This review summarizes the available data on the topic of pregnancy dermatoses and validates the classification in four definite groups: herpes gestationis, polymorphic eruption of pregnancy, prurigo of pregnancys and pruritic folliculitis of pregnancy.

Pruritic folliculitis of pregnancy

Pruritic folliculitis of pregnancy is a rare pregnancy dermatosis that clears spontaneously in the postpartum period. We describe a patient with characteristic clinical and histopathologic features of this dermatosis. (J Am Acad Dermatol 2000;43:132-4.)

Specific Dermatoses of Pregnancy

THE INFLAMMATORY dermatoses that occur during pregnancy have been reported under a variety of confusing terms,<i>such as erythema multiforme of pregnancy,1 prurigo annularis,2 toxaemic rash of pregnancy,3 prurigo gestationis of Besnier,4 late-onset prurigo of pregnancy (PP),5 pruritic urticarial papules and plaques of pregnancy,6 and papular dermatitis of pregnancy.7</i>Only dermatologists could have so many denominations for clinical situations whose exact pathogenesis and cause are not known and that may in fact belong to the same disease entity! With the exception of pemphigoid (herpes) gestationis (PG), we know of no criteria that can be used to differentiate these conditions.⁸Holmes and Black^9,10came to a similar conclusion and, in an attempt to rationalize the obsolete nomenclature, proposed a classification that included four entities: PG, polymorphic eruption of pregnancy (PEP), PP, and pruritic folliculitis of pregnancy (PFP).¹⁰The hope that this

The specific dermatoses of pregnancy

The terminology of the specific dermatoses of pregnancy has become increasingly confusing, with several names in use for identical clinical disorders. On the basis of our own study of sixty-four patients and a review of the literature, we propose a simplified classification: (1) herpes gestationis (pemphigoid gestationis); (2) polymorphic eruption of pregnancy; (3) prurigo of pregnancy; and (4) pruritic folliculitis of pregnancy.